224234 Access to health care and health services: An in-dept formative evaluation of recent refugee women's access at the Massachusetts General Hospital (MGH) Chelsea HealthCare Center

Tuesday, November 9, 2010 : 12:30 PM - 12:45 PM

Chantal J. F. Kayitesi, LPN, MPH , Community Health Improvement, Massachusetts General Hospital -Chelsea HealthCare Center, Chelsea, MA
Sarah A. Oo, MSW , Community Health Improvement, Massachusetts General Hospital -Chelsea HealthCare Center, Chelsea, MA
Danelle Marable, MA , Center for Community Health Improvement, Massachusetts General Hospital, Boston, MA
Lisa Sibert Carr, MD , Pediatric and Adult Medecine, Massachusetts General Hospital -Chelsea HealthCare Center, Chelsea, MA
Tamara J. Leaf, PsyD , Mental Health and Social Services, MGH Chelsea HealthCare Center, Chelsea, MA
Refugee women have unique health needs resulting from their experience with war, cultural and religious beliefs, illiteracy, poverty and resettlement stress. To determine the scope and factors that influence refugee women's access to health care at a hospital-run community health center, we conducted an in-depth assessment from May to August 2009. The assessment included a literature review, 115 patient record review, 25 interviews with refugee women, and 45 key informant interviews. Our findings confirmed disparities in accessing preventive care, preconception, perinatal and interconception care, chronic disease management and mental health services. Patients' records revealed low rates of recommended screenings. The rate of mammography screening was 58.9% for women aged 40 and older versus 84% in Massachusetts; Pap smear rate was 8.5% for women 24 and older and 13.3 % for those 13 to 23 years versus 92.1% in MA. The rate of chronic diseases was 54% (diabetes, obesity, and hypertension). Lack of data on health care utilization and outcomes for refugees and some immigrant groups was another area of disparity. The main barriers to care were lack of understanding of the health care system, language, cultural and religious beliefs and health seeking behaviors motivated by acute symptoms. Underutilization of mental health was due to stigma, low locus of control and limited capacity for culturally competent care. Finally, refugee women were burdened by basic needs and overlooked their own health. A newly developed intervention and strategies to respond to the identified needs and better coordinate care will be described.

Learning Areas:
Assessment of individual and community needs for health education
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs

Learning Objectives:
-Describe the process used in assessing the needs of refugee women -Identify the factors that affect access to health care for refugee women -Explain the rationale behind the new intervention design and strategy development

Keywords: Access to Health Care, Refugees

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract Author because I coordinate the Refugee Women's Health Access Program at MGH Chelsea HealthCare Center
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.